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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Subtle problems of perplexity, distractibility, and fatigue accompany all kinds of brain injury for they appear to result from disruption of accustomed neural pathways and loss or change of mental function. Emotional disturbances may mask these subtle problems, but they can also result from them. Clinical experience indicates that these problems are more apt to become stressful when the patient misinterprets or copes ineffectively with them. That these common problems of brain injured adults may be overlooked in the usual clinical examination was shown in a comparison of clinical records of 50 patients referred for neuropsychological consultation with records of 46 patient-participants in a longitudinal neuropsychological study. Significantly more reports of these problems appeared in the latter group of records. However, consultation records did reflect emotional distress. Irritability, depression, or anxiety affected all but six consultation patients and appeared with equal frequency among working patients as among those unable to work or needing full-time care. This suggests that some of their emotional distress resulted from less obvious problems than those impairing mobility, strength, or competency. Counseling can reduce the patient's vulnerability to the psychologically crippling effects of perplexity, distractibility, and fatigue. Specific recommendations for patient and family counseling are offered.
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PMID:Subtle sequelae of brain damage. Perplexity, distractibility, and fatigue. 2 22

Two-hundred and eight patients with chronic fatigue syndrome (post-viral fatigue syndrome) completed a questionnaire which dealt both with their illness in general and with the extent to which they experienced specific symptoms. A factor analysis of the symptom data yielded four components: emotional distress; fatigue; somatic symptoms; and cognitive difficulty. Emotional disturbance is a common feature of the disorder and its role has been widely debated. When the symptom components were considered independently, fatigue, somatic symptoms and cognitive difficulty were associated with questionnaire items relating to general illness severity, but emotional distress was not. Thus negative emotions did not contribute directly to patients' perception of illness severity. They were, however, correlated with the other symptom components. It is argued that this correlation reflects a reciprocal influence, with negative emotions exacerbating fatigue and other key symptoms and the debilitating nature of these symptoms enhancing emotional vulnerability.
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PMID:Illness perception and symptom components in chronic fatigue syndrome. 156 77

Fifteen patients, with a primary complaint of chronic fatigue, were referred to a physician by their general practitioners. Psychological distress, measured by simple psychiatric rating scales was common, but specific psychiatric diagnoses, derived from a comprehensive diagnostic interview, occurred less frequently. One questionnaire (Montgomery-Asberg depression rating scale) found emotional distress in 93%, but the diagnostic instrument (Present State Examination) suggested depressive syndromes in only two patients (13%). There were significant occupational difficulties in 87%. No consistently abnormal indices of biochemical or immunological function were found, nor evidence of acute or chronic infection. Chronic fatigue syndrome (CFS) is associated with physical, psychological and social distress. The illness cannot be defined using just one of these dimensions. Such a unilateral approach has resulted in unnecessary controversy over the nature of the 'real' core of CFS. A problem-oriented approach, recognising the multi-factorial and overlapping cause and effect issues in CFS, may be of more benefit to patients.
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PMID:Biopsychosocial aspects of chronic fatigue syndrome (myalgic encephalomyelitis). 175 34

The associations between exercise capacity, symptoms and specific aspects of quality of life were examined in subjects participating in a trial of the treatment of heart failure. Patients were assessed on entry and after three months treatment. The principle symptoms were fatigue, breathlessness and chest pain. These limited the extent and speed of physical activities, restricted social, leisure and family life and were associated with emotional distress. There were associations between baseline exercise capacity and measures of quality of life. Change in exercise capacity during three months treatment was correlated with changes in measures of symptoms, limitation of activity and quality of life. The findings confirm the value of change in exercise capacity as a measure of functional status and suggest that it should be supported by a limited number of specific measures of quality of life.
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PMID:Cardiac failure: symptoms and functional status. 192 Jan 71

The study reports the results of a preliminary investigation into the incidence of symptom distress in two cancer patient populations--those receiving chemotherapy and those undergoing radiotherapy--and discusses the further evaluation of a symptom distress scale. The scale is found to be both reliable and valid for use in both patient populations. The results indicate that, although overall symptom distress is similar between chemotherapy and radiotherapy patients, there is considerable individual variation in the extent of that distress and the symptoms causing distress may differ between the groups. As in previous studies, tiredness was the most common complaint. Those patients receiving chemotherapy also complained of an inability to concentrate, mood changes and alterations in appearance. Those undergoing radiotherapy most commonly reported significant distress due to pain, altered appearance, constipation and appetite change. The findings suggest that the Symptom Distress Scale may be a useful addition to the assessment of individual patients and may provide a means by which the effects of interventions, designed to alleviate physical distress, could be evaluated.
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PMID:Preliminary investigations of symptom distress in two cancer patient populations: evaluation of a measurement instrument. 206 7

A modified version of the McCorkle & Young Symptom Distress Scale, based on a linear analogue self-assessment scoring system, was used to assess symptom distress in a heterogeneous sample of 53 cancer patients. The scale was simultaneously completed by the nurses caring for those patients, who were asked to rate the patient according to how they perceived he was feeling with regard to each particular symptom. The scores were compared for congruency. This preliminary study suggests that, although nurses appear able to estimate the degree of distress due to changes in mobility and appearance or the presence of diarrhoea, constipation and tiredness, they are less effective in perceiving the degree of distress due to the less 'visible' symptoms such as pain, nausea, anorexia, sleeping disturbances, concentration and mood. Perhaps surprisingly, the trend was for nurses to overestimate the degree of distress when this was compared with the patients' self-assessment.
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PMID:Patients' and nurses' perceptions of symptom distress in cancer. 280 38

Chemotherapy side effects, patient distress, and patient-practitioner communication were evaluated in an inception sample of 238 patients with breast cancer or malignant lymphoma. Participants were interviewed at five points during their first six cycles of therapy, and a subsample kept brief daily symptom diaries. Nausea, hair loss, and tiredness were each experienced by more than 80% of patients. By cycle 6, 46% of patients had thoughts about quitting therapy, but only a few had told medical staff. Patients' ratings of the objective difficulty of treatment increased over time, varied by treatment regimen, and were predicted by the experience of side effects, with the number of different side effects serving as the best predictor. In contrast, emotional distress was less sensitive to the directly assessable characteristics of treatment. Communication between patient and practitioner was found to be inadequate in a number of respects (i.e., patients did not fully anticipate the toxicities of treatment and did not report their concerns to medical staff). Communication may be impeded by inaccuracies in a patient's recall of treatment difficulties and by a patient's inability or unwillingness to attend to all presented information. More frequent opportunities for patient-practitioner discussion are necessary.
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PMID:Side effects and emotional distress during cancer chemotherapy. 291 36

A questionnaire has been developed for use as an outcome measure in clinical trials of adjuvant chemotherapy in women with stage II breast cancer. The selection of items for this Breast Cancer Chemotherapy Questionnaire (BCQ) was based on the problems and experiences felt to be most important by women undergoing adjuvant chemotherapy. The BCQ consists of 30 questions that focus on loss of attractiveness, fatigue, physical symptoms, inconvenience, emotional distress, and feelings of hope and support from others. The BCQ, other instruments that evaluate quality-of-life (Spitzer, Karnofsky, and Rand), and patient and physician global assessments were administered serially to 418 patients taking part in a randomized trial comparing a 12-week regimen and a 36-week regimen of adjuvant chemotherapy. The validity of the BCQ is supported by its correlation with the Rand Emotional (r = .58), Rand Physical (r = .60), and Spitzer (r = .62) questionnaires. The BCQ correlated more strongly with global ratings of both physical and emotional function by the patients and their physicians than the other instruments. A comparison of the quality-of-life outcomes of patients in the two treatment groups in the period beyond 3 months after initiation of treatment, when one group had completed the treatment course and the other was still on treatment, revealed that the BCQ and Karnofsky were the only instruments able to demonstrate differences between the groups (P less than .0001). Hence, the BCQ is a valid and responsive method of assessing treatment-related morbidity in patients receiving adjuvant chemotherapy for stage II breast cancer.
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PMID:Quality of life in stage II breast cancer: an instrument for clinical trials. 292 75

This investigation examined the receipt of professional counseling services in response to problems related to stress in one state-wide sample of special education teachers. An analysis of variance was conducted for each stress variable to estimate the significance of mean differences between groups of counseling recipients and nonrecipients. Most comparisons indicated significantly stronger and more frequent stressful experiences for counseling recipients than for nonrecipients with respect to scores on Professional Distress, Emotional Manifestations, Physiological-Fatigue Manifestations, and Total Stress.
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PMID:Occupational stress and receipt of professional counseling in special education. 343 46

The incidence of physical toxicity and psychosocial effects associated with adjuvant chemotherapy for stage II breast cancer have been reported in previous studies. The purpose of this exploratory study was to quantify the degree of physical and psychologic distress experienced by patients and identify life-style changes. A semistructured interview was conducted with 78 subjects to elicit demographic data, distress, and life-style changes using the Symptoms Distress Scale (SDS), the Psychiatric Status Schedule (PSS), and questions and scales developed by the investigator. All subjects received adjuvant chemotherapy (cyclophosphamide, methotrexate, and 5-fluorouracil with or without vincristine and prednisone) following primary treatment for breast carcinoma. Fifty subjects were currently on therapy and 28 had completed treatment. Fatigue was the most distressful physical symptom. Although physical distress was rated higher by subjects receiving treatment, generally all rating scores indicated only mild symptom distress. Subjects perceived more distress for the psychologic and emotional response to disease and treatment, and this persisted for women who completed therapy. Changes in role performance and daily activity were minimal.
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PMID:Physical and psychologic distress associated with adjuvant chemotherapy in women with breast cancer. 375 73


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